Cosmetic allergy: incidence, diagnosis, and management

Unveiling the phyto-restorative potential of ethereal distillates for atopic dermatitis: an advanced therapeutic approach

Atopic dermatitis is acknowledged as a vital inflammatory disorder associated with the integumentary system of the body and is characterized by the formation of thick reddish-grey scars and erythema formation on skin, prevalent amidst the populace. Numerous synthetic drugs are available for treatment like antihistamines, immunosuppressants, glucocorticoids etc., but contrarily, essential oil therapy is exclusively lime lighted to favour the purpose. The utilization of available engineered drugs, possess the marked adverse effects owing to prolonged duration of therapy and therefore, essential oils are explored well and proved to exhibit the anti-eczematic, anti-inflammatory and antipruritic properties. Ethereal distillates own the assorted and selective therapeutic properties attributable to presence of bioactive compounds liable to treat this torturous and integumentary disorder, likely lavender oil, patchouli oil, frankincense oil etc., have been found to exert their pharmacological actions by impeding the liberation and action of inflammatory mediators and immunological hyperactivities that are engaged in exacerbating this idiopathic illness. The current attempt provided the update with the aim to bring forth the naturally originated treatment that is pertinent to provide the invulnerable therapy by circumventing the noxious symptoms i.e. erythema formation and inflamed lesions.

Potential for Allergic Contact Dermatitis in Popular Hair Care Practices and Ingredients

The incidence of allergic contact dermatitis (ACD) due to personal care products is rising in parallel with increasing product availability and consumer interest. Hair products specifically represent a significant source of potential allergens, including preservatives, surfactants, emulsifiers, fragrances, adhesives, and dyes. ACD due to hair care products can present as dermatitis in the distinctive "rinse-off" distribution, involving the neck, eyelids, and lateral face in addition to the scalp. Herein, the authors review ingredients in hair care products that can cause ACD and practical tips for allergen identification.

Glycolipid Biosurfactants in Skincare Applications: Challenges and Recommendations for Future Exploitation

The 21st century has seen a substantial increase in the industrial applications of glycolipid biosurfactant technology. The market value of the glycolipid class of molecules, sophorolipids, was estimated to be USD 409.84 million in 2021, with that of rhamnolipid molecules projected to reach USD 2.7 billion by 2026. In the skincare industry, sophorolipid and rhamnolipid biosurfactants have demonstrated the potential to offer a natural, sustainable, and skin-compatible alternative to synthetically derived surfactant compounds. However, there are still many barriers to the wide-scale market adoption of glycolipid technology. These barriers include low product yield (particularly for rhamnolipids) and potential pathogenicity of some native glycolipid-producing microorganisms. Additionally, the use of impure preparations and/or poorly characterised congeners as well as low-throughput methodologies in the safety and bioactivity assessment of sophorolipids and rhamnolipids challenges their increased utilisation in both academic research and skincare applications. This review considers the current trend towards the utilisation of sophorolipid and rhamnolipid biosurfactants as substitutes to synthetically derived surfactant molecules in skincare applications, the challenges associated with their application, and relevant solutions proposed by the biotechnology industry. In addition, we recommend experimental techniques/methodologies, which, if employed, could contribute significantly to increasing the acceptance of glycolipid biosurfactants for use in skincare applications while maintaining consistency in biosurfactant research outputs.

Microbial Biosurfactant as an Alternate to Chemical Surfactants for Application in Cosmetics Industries in Personal and Skin Care Products: A Critical Review

Cosmetics and personal care items are used worldwide and administered straight to the skin. The hazardous nature of the chemical surfactant utilized in the production of cosmetics has caused alarm on a global scale. Therefore, bacterial biosurfactants (BS) are becoming increasingly popular in industrial product production as a biocompatible, low-toxic alternative surfactant. Chemical surfactants can induce allergic responses and skin irritations; thus, they should be replaced with less harmful substances for skin health. The cosmetic industry seeks novel biological alternatives to replace chemical compounds and improve product qualities. Most of these chemicals have a biological origin and can be obtained from plant, bacterial, fungal, and algal sources. Various biological molecules have intriguing capabilities, such as biosurfactants, vitamins, antioxidants, pigments, enzymes, and peptides. These are safe, biodegradable, and environmentally friendly than chemical options. Plant-based biosurfactants, such as saponins, offer numerous advantages over synthetic surfactants, i.e., biodegradable, nontoxic, and environmentally friendly nature. Saponins are a promising source of natural biosurfactants for various industrial and academic applications. However, microbial glycolipids and lipopeptides have been used in biotechnology and cosmetics due to their multifunctional character, including detergency, emulsifying, foaming, and skin moisturizing capabilities. In addition, some of them have the potential to be used as antibacterial agents. In this review, we like to enlighten the application of microbial biosurfactants for replacing chemical surfactants in existing cosmetic and personal skincare pharmaceutical formulations due to their antibacterial, skin surface moisturizing, and low toxicity characteristics.

Development and Validation of an Instrument to Appraise the Tolerability, Safety of Use, and Pleasantness of a Cosmetic Product

Background: Acceptability tests are designed to demonstrate that there is no chance that cosmetics would irritate or distress users in day-to-day situations. Objectives: to develop and validate a tool or scale that dermatologists, general practitioners, and other healthcare professionals can employ to assess a cosmetic product’s tolerability, safety of usage, and pleasantness. Methods: A three-step modified Delphi technique was used in the consensus process. Two rounds of online surveys and a final face-to-face meeting were performed. Fifty experts for the Delphi panel were chosen to reflect a holistic array of expertise and perspectives in pharmacovigilance, dermatology, and cosmetic safety assessments. In round 1, 80 statements and 115 statements related to skin tolerance and cosmetic safety/efficacy, respectively, were distributed to all members of the expert panel. The expert panel was asked to rate the extent to which they agreed with each statement in the questionnaire using a 5-point Likert scale and given a chance to include a remark beside each item. A statement had to receive 80% of the panel’s approval to be accepted. Results: A total of 50 professional experts were recruited in the Delphi questionnaire rounds (response rate = 63%). The expert panel reached a consensus on 30 statements to evaluate skin tolerability and 34 statements to evaluate cosmetic safety and efficacy (agreement rate level ≥ 80%). The experts also proposed a generic, systematic approach that would allow patients to report both functional and physical symptoms in addition to those discovered during an examination (clinical signs). The confrontation of these symptoms determines whether the investigated cosmetic product is ultimately cutaneously acceptable. Conclusion: The tool that was proposed during this study offered good content validity. Future studies are recommended to test the developed tools in practice to evaluate the good skin compatibility and the safety and quality of cosmetics in the UAE and other nations.

Contribution of Patch Tests with Occupational Handled Products in the Diagnosis of Occupational Contact Dermatitis: A 10-year Review

Introduction

Allergic contact dermatitis (ACD) is a common occupational disease. Its diagnosis is essentially based on interrogation and patch tests. However, commercially available batteries are sometimes not appropriate for the working conditions and the handled products, which must then be tested. In Tunisia, no previous study has focused on the contribution of patch tests with handled products in the workplace. The objective of this study is to establish the sociodemographic and occupational profile of the patients benefiting from patch tests with handled products in the workplace to identify the characteristics of these products as well as to evaluate the relevance of their positivity and their contributions in terms of aetiological diagnosis of occupational ACD.

Methods

This is a retrospective descriptive epidemiological study conducted for a period of 10 years from January 1^st, 2006, to December 31, 2015, among patients exercising a professional activity and consulting the Dermato-Allergology Unit of the Occupational Medicine ward of the University Hospital Farhat Hached of Sousse for the exploration of ACD.

Results

During the study period, 113 patients received patch tests of handled products in the workplace with a prevalence of 7.3% of patch-tested patients during the same period. The mean age was 35.79 ± 9.45 years with a male predominance (sex ratio = 1.35). The most represented activity sectors were the health sector in 30.1% and the textile sector in 21.2%. The majority of patients were professionally active (61.9% of the study population) with an average professional seniority of 10.28 ± 8.49 months. In total, 138 patch tests with handled products were carried out of which 46 tests were positive (33.3%). After the analytical study, variables independently significantly associated with the positivity of patch tests with handled products in the workplace were the male gender and the working in the plastics industry. An occupational disease was declared to the National Health Insurance Fund for 8 patients, i.e., 7.1% of cases.

Conclusion

Patch tests with handled products in the workplace can provide strong arguments for the professional origin of the ACD.

Contact allergens for the allergist

OBJECTIVE

The objective of this article is to provide an overview and describe typically encountered skin contact allergens implicated in allergic contact dermatitis (ACD).

DATA SOURCES

Published literature obtained through textbooks, online PubMed, and Google Scholar database searches, author photography, and adapted figures were used.

STUDY SELECTIONS

Studies on the evaluation of ACD and specific skin contact allergens were selected, with a focus on original research articles and clinical reviews.

RESULTS

Major classifications of common contact allergens include the following: (1) fragrances, (2) preservatives, (3) excipients, (4) rubber chemicals, (5) textile dyes, (6) topical medications, and (6) metals and other biomedical device components. The dermatitis distribution can aid in identifying the suspected contact allergen culprit. Certain contact allergens have features that are important to consider in the patch testing (PT) interpretation; these include possible irritant reactions, false-negative reactions or missed detection, and delayed reactions. Fragrances, preservatives, and excipients are culprits in personal products and facial or neck dermatitis. Patch testing with fragrances, preservatives, and patient-supplied products requires careful interpretation. Hand or foot dermatitis may be attributed to rubber chemicals or textile dyes. The management of topical corticosteroid contact allergy is guided on the basis of structural group classifications. Metal sensitization has been associated with dermatitis or biomedical device complications.

CONCLUSION

Each skin contact allergen has unique characteristics with regard to the dermatitis clinical presentation and potential PT nuances. These features are critical to recognize in the evaluation of ACD and PT interpretation and clinical relevance, leading to an accurate diagnosis.

Green, rapid and simultaneous determination of 'alternative preservatives' in cosmetic formulations by gas chromatography-mass spectrometry

Some hydroxylated compounds commonly used in cosmetic formulations including short chain glycols, benzylic alcohols, and organic acids show antimicrobial activity, although they are not considered as preservatives according to the existing European legislation. These 'alternative preservatives' are not exempt of potential side-effects for cosmetics users. The aim of this work is to develop a simple and affordable analytical method useful for the simultaneous and green determination of fourteen compounds used as 'alternative preservatives' in cosmetic samples with different matrices. The proposed method allows a rapid sample preparation by simple dissolution or dispersion of the sample in ethanol using ultrasound-assisted leaching of the analytes from the cosmetic matrix. Gas chromatography coupled to mass spectrometry (GC-MS) is used for the analysis of the samples. Working conditions for the instrumental measure and the quantification of analytes were studied. The method was found to have high sensitivity and good precision (relative standard deviation below 13%) as well as low limits of detection (i.e., 0.01·10^-3-2.14·10^-3% w/w) and quantification (i.e., 0.04·10^-3-7.14·10^-3% w/w). The method was successfully applied to five commercial cosmetic samples of different composition. Recovery values near 100% were obtained. Each sample was found to contain at least three of the analytes of the study and their concentrations were determined with low standard deviations. The analytical features of the proposed method and the obtained results agree with the principles of Green Analytical Chemistry and make it a useful tool for controlling these alternative preservatives in the cosmetic industry in order to guarantee quality and safety of the products.

Contact Dermatitis in Nail Cosmetics

Many ingredients found within nail cosmetic products are capable of sensitizing patients’ immune systems and causing contact dermatitis (CD). These include but are not limited to tosylamide, (meth)acrylates, and formaldehyde. A clear temporal relationship between nail cosmetic procedures and an eczematous outbreak on the hands, face, or other ectopic body regions can be a key indicator of CD secondary to nail cosmetic exposure. Once an inciting allergen is identified through patch testing, elimination and avoidance becomes a mainstay of treatment alongside the use of emollients and topical anti-inflammatory therapies. Patients should be counselled to approach future nail cosmetic products and procedures with caution and careful attention to ingredients, regardless of whether or not it has a “hypoallergenic” label.

Fragrance, Sunscreens, Botanicals, and Potential Allergens in Bestseller 'Fairness' Creams in the Indian Market: A Consumer Exposure Study

Background

The skin lightening industry has seen exponential growth in India. Consumers often present to the dermatologist with adverse cutaneous reactions to these 'fairness' (skin lightening) creams. The composition of these creams has not received sufficient attention.

Objective

To identify fragrance, sunscreens, botanicals and potential allergens in the bestseller 'fairness' creams available in the Indian market.

Methods

Twenty fairness (or whitening or lightening) creams were selected based on the 'bestseller' creams of one of the largest electronic commerce websites in India, and availability in local stores and unlabelled brands were excluded. Fragrance, sunscreens, botanicals and potential allergens were identified from the ingredient labels.

Results

Twenty bestseller fairness creams were included. The number of the listed ingredients in the fairness creams ranged from 6 to 49 (mean = 32.2). The most frequently listed ingredients included water, fragrance or parfum, glycerin, tocopherol/tocopherylacetate and titanium dioxide. Hydroquinone, monobenzyl hydroquinone, corticosteroids, tretinoin and mercury were not listed in any of the creams. Unspecified fragrance was listed in 19 (95%) creams and linalool (8,40%) was the most frequent specified fragrance. Titanium dioxide (14, 70 %) was the most common inorganic sunscreen and ethylhexyl methoxycinnamate (12 creams or 60% of creams) was the most common organic sunscreen. Twenty-seven botanicals were identified. Eight ingredients were potential allergens according to the Indian Cosmetic and Fragrance Series. The cost of the creams ranged from 95 to 1,095 in Indian rupees (mean 300.5).

Conclusions

Consumers are exposed to a vast range of compounds in the quest for a lighter skin tone. Several potential allergens, particularly fragrance allergens, are present in addition to the eight allergens that were identified with the Indian Cosmetic and Fragrance Series. Increased awareness of the composition of skin lightening creams available in the market and strict regulation of these creams is needed.

Microbial Biosurfactants in Cosmetic and Personal Skincare Pharmaceutical Formulations

Cosmetic and personal care products are globally used and often applied directly on the human skin. According to a recent survey in Europe, the market value of cosmetic and personal care products in Western Europe reached about 84 billion euros in 2018 and are predicted to increase by approximately 6% by the end of 2020. With these significant sums of money spent annually on cosmetic and personal care products, along with chemical surfactants being the main ingredient in a number of their formulations, of which many have been reported to have the potential to cause detrimental effects such as allergic reactions and skin irritations to the human skin; hence, the need for the replacement of chemical surfactants with other compounds that would have less or no negative effects on skin health. Biosurfactants (surfactants of biological origin) have exhibited great potential such as lower toxicity, skin compatibility, protection and surface moisturizing effects which are key components for an effective skincare routine. This review discusses the antimicrobial, skin surface moisturizing and low toxicity properties of glycolipid and lipopeptide biosurfactants which could make them suitable substitutes for chemical surfactants in current cosmetic and personal skincare pharmaceutical formulations. Finally, we discuss some challenges and possible solutions for biosurfactant applications.

Developing a cosmetic series: Results from the ESSCA network, 2009-2018

BACKGROUND

There is considerable variability across European patch test centres as to which allergens are included in local and national cosmetics series.

OBJECTIVES

To propose a standardized, evidence-based cosmetic series for Europe based on up-to-date analysis of relevant contact allergens.

METHODS

We collated data from the European Surveillance System on Contact Allergies (ESSCA) from 2009 to 2018 to determine which cosmetic allergens produce a high yield of contact allergy. Contact allergens with a prevalence of >0.3% that were considered relevant were included. Rare contact allergens were excluded if deemed no longer relevant or added to a supplemental cosmetic series for further analysis.

RESULTS

Sensitization prevalences of 39 cosmetic contact allergens were tabulated. Thirty of these allergens yielded >0.3% positive reactions and are therefore included in our proposed European cosmetic series. Six were considered no longer relevant and therefore excluded. Three were included in a supplementary European cosmetic series. An additional nine allergens were included in either the core or supplemental European cosmetic series following literature review.

CONCLUSION

We have derived a potential European cosmetic series based upon the above methods. This will require ongoing investigation based upon the changing exposure profiles of cosmetic allergens as well as new and evolving substances.

Relations between Contact Duration, Type of Work Use of Personal Protective Equipment and Contact Dermatitis among Electroplaters

 Introduction: Occupational contact dermatitis is defined as a skin disorder that occurs after work and caused by work process. Electroplating is one of the jobs which has  high contact dermatitis risk because there are irritant chemicals such as nickel and chromium. This study aimed to identify the relationship between risk factors for occupational-induced contact dermatitis and  electroplaters at CV. X and CV. Y, Durungbanjar Village, Sidoarjo District. Method: This research was an observational study using cross-sectional approach. The sample was a total population of 28 people, consisting of 13 electroplaters at CV. X and 15 electroplaters at CV. Y in Durungbanjar Village. The study was conducted in November - May 2019. Data were collected using questionnaires, observations and medical record sheets. The variables in this study were contact duration, contact frequency, type of work and the use of personal protective equipment. Result: Result showed that 64.3% of electroplaters suffered from contact dermatitis. Contact duration factor had a very strong correlation of c = 0.764, contact frequency factor had a strong correlation of c = 0.710, type of work had strong correlation of c = 0.616, personal hygiene factor had strong correlation of c = 0.547 and the use of personal protective equipment also had strong correlation of c = 0.545. Conclusion:  There is a very strong correlation between contact duration and contact dermatitis. Contact frequency, type of work and the use of personal protective equipment had strong correlation to contact dermatitis among electroplaters. The higher contact duration and frequency with irritant substances among the electroplaters, the higher the increase of the risk of contact dermatitis among the electroplaters. Some occupational efforts and recommendations can be made to reduce the risk of contact dermatitis. Keywords: contact dermatitis, electroplating, risk factors

Insight of Malaysian Users of Cosmetic Regarding Cosmetovigilance

Despite high popularity and demand for cosmetic products among users of cosmetics, there is paucity of work on cosmetovigilance. The objective of this study was to explore the cosmetovigilance-related insight encompassing the knowledge, practices, attitude, and perception of Malaysian users of cosmetics. A cross-sectional study was conducted using a structured questionnaire comprising of 47 items reflecting on demographic profile, knowledge, practices, attitude, and perception toward cosmetics. The questionnaire was administered using the SurveyMonkey website, subject to a convenience sample of 552 users of cosmetics in Malaysia. The data collected were analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Insufficient knowledge of cosmetic safety was found, especially in terms of the ingredients used and the adverse effects related to common cosmetic products. The total knowledge score showed a significant difference between gender (p < 0.001) and monthly expenditure (p = 0.001). The total attitude score showed a significant difference with respect to gender (p = 0.008), age (p < 0.001), marital status (p < 0.001), education (p = 0.014), occupation (p < 0.001), income range (p = 0.009) and monthly expenditure (p = 0.013). The levels of cosmetovigilance-related knowledge, practices, attitude and perception of users of cosmetics in Malaysia are still unsatisfactory. The current research is expected to offer baseline data which can further help in strengthening the knowledge and attitudes of cosmetic consumers, while reinforcing best practices towards cosmetic products.

An observational study on adverse reactions of cosmetics: The need of practice the Cosmetovigilance system

Introduction

Cosmetovigilance is public health surveillance on cosmetic products with a public health objective. Since the radical development in beautifying products in Saudi Arabia, the Saudi Food and Drug Authority takes the responsibility of regulating cosmetic products and issuing guidelines to ensure its safety. Despite this, there exists a lacuna of Re published reports on cosmetics-related adverse reactions in the Saudi population. We aimed to assess self-reported adverse reactions in the general public of the Eastern Province, Saudi Arabia.

Materials and Method

A cross-sectional study was conducted for three months. The questionnaire for data collection was adopted and modified from previous studies for the cosmetic utilization behaviors and adverse reactions.

Results

Among the 425 participants, 50.6% reported that they had at least one adverse reaction in the past two years. Redness of the skin (19%), pimples (15%), and itching (13%) were the commonly reported adverse reactions. The majority of the adverse reactions were reported with hair care (29%) and skincare products (25%). The majority [n = 181 (84.2%)] of the participants with managed the ARs by the cessation of the product use. The univariate analysis found that gender, age, allergic to medications and food, family history of allergy, mixing cosmetics, and frequent switching of cosmetic brands were associated with adverse events. However, the adjusted analysis found that allergic to medication (adjusted OR: 3.9), family history of allergy (adjusted OR: 1.91), and mixing cosmetics (adjusted OR: 1.70) were significantly associated with cosmetics-related adverse reactions.

Conclusion

Cosmetovigilance is a model of safety monitoring of cosmetics. It can be considered as a one of the element in public health activities. Pharmacists should be more vigil on this issue in the near future. To strengthen the findings further, a national wide prevalence study can be conducted prospectively and analyses causality and report to the pharmacovigilanvce system of the country.

Camouflage makeup improves quality of life in cancer patients with treatment-related skin changes

BACKGROUND

Cancer treatment causes various skin appearance changes, which affect quality of life (QoL) in patients with cancer. We examined whether camouflage makeup improves QoL in these patients.

METHODS

Skindex-16 and visual analogue scale scores of 39 female patients with cancer treatment-related skin changes were compared before and 2-3 months after self-administration of camouflage makeup.

RESULTS

Camouflage makeup was able to conceal almost all skin changes, improving QoL scores regardless of age, diagnosis, and site of skin changes. Use frequency was significantly higher in patients with skin changes on exposed sites compared with patients with unexposed sites.

CONCLUSIONS

Even though the patients applied the makeup only when required, they were satisfied with its effect, which improved their QoL. Moreover, the makeup had a positive effect even in patients with changes in unexposed sites, suggesting that clinicians can recommend camouflage makeup to all patients to improve QoL.

Antimicrobial Ingredients as Preservative Booster and Components of Self-Preserving Cosmetic Products

This review reports cosmetic ingredients with antimicrobial activity including synthetic and natural (plant and microbial) origin as alternative for preservatives used in cosmetics as well described mechanism of their action.

Potentiation of skin TSLP production by a cosmetic colorant leads to aggravation of dermatitis symptoms

Certain cosmetic colorants are irritant to skin or aggravate dermatitis. Thymic stromal lymphopoietin (TSLP) plays an important role in the initiation and progress of skin inflammation and atopic dermatitis by triggering Th2 immune responses. However, the effects of cosmetic colorants on TSLP production are unknown yet. Therefore, we investigated whether cosmetic colorants regulated TSLP production and dermatitis. Lithol Rubine B (LR-B, Pigment Red 57) and its calcium salt (LR-BCA), commonly used cosmetic colorants, potentiated phorbol-12-myristate-13-acetate-induced TSLP production in keratinocytes. In addition, the topical exposure to LR-B or LR-BCA on mouse ear upregulated a TSLP inducer (MC903)-induced TSLP production and Th2 cytokine expression. Dermatitis symptoms and serum IgE and histamine levels were also aggravated by LR-B or LR-BCA, implicating the role of increased TSLP expression in acute dermatitis. LR-B or LR-BCA induced IκBα degradation and NF-κB activation in keratinocytes, leading to TSLP expression. Collectively, our results demonstrate that LR-B and LR-BCA increase TSLP expression and Th2 immune responses, thereby aggravating acute dermatitis in the compromised skin. The results further suggest that certain cosmetic colorants such as LR-B may aggravate dermatitis under pro-inflammatory conditions by upregulating TSLP production.

Allergy to hypoallergenic nail polish: does this exist?

The main allergen responsible for contact dermatitis to nail polish is tosylamide-formaldehyde resin. The so-called hypoallergenic nail polishes are suposedly free of agents that commonly trigger reactions. The commercially available products and their compositions were studied. It was observed that most brands present at least one component capable of triggering the disease; therefore, allergic reaction may occur even when hypoallergenic polishes are used. There should be a proper investigation of the specific allergen through a patch test, because more than one component can cause an allergy, and we need to check the exact composition of each product.

Cosmetics Use-Related Adverse Events and Determinants Among Jigjiga Town Residents, Eastern Ethiopia

Introduction

Non-medicated cosmetics use is very common among the Ethiopian population. However, little is known about these products’ related adverse events. The aim of this study was to assess the prevalence and determinants of cosmetics-related adverse events among Jigjiga Town residents, Eastern Ethiopia.

Methods

A community-based cross-sectional study design was conducted in May and June 2014. Semi-structured interviews were used to collect cosmetics use pattern and related adverse events. For assessing determinants, logistic regression was used and statistical significance was set at p < 0.05.

Results

Overall, 600 participants were approached with a 93% response rate. Ninety-three percent (n = 521) of them reported the use of cosmetics at least once within 2 weeks prior to this study, and of these, 229 (44%) used traditional herbal cosmetics along with modern cosmetics. A total of 342 (61%) reported experiencing adverse events of which the most common reported were: allergic reactions, 149 (36%); the appearance of acne, 66 (16%); and hirsutism, 52 (12.5%). The occurrence of cosmetics-related adverse events were significantly associated with the number of cosmetics used per day, the frequency of use, mixing of different types of cosmetics together, and mixing of cosmetics with water or saliva.

Conclusion

A higher proportion of cosmetic users reported experiencing at least one adverse event. The number of cosmetic products and frequency of use were important predictors for experiencing adverse events. This implies the need to consider safety concerns related to cosmetic use. Approaches to address such issues may include awareness creation programs and promoting the concept of cosmetovigilance among cosmetic sellers, users, and other stakeholders.

Contact dermatitis: a practice parameter-update 2015

This parameter was developed by the Joint Task Force on Practice Parameters, which represents the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology. The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Contact Dermatitis: A Practice Parameter-Update 2015." This is a complete and comprehensive document at the current time. The medical environment is changing and not all recommendations will be appropriate or applicable to all patients. Because this document incorporated the efforts of many participants, no single individual, including members serving on the Joint Task Force, are authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information or interpretation of this practice parameter by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma & Immunology. These parameters are not designed for use by the pharmaceutical industry in drug development or promotion. Previously published practice parameters of the Joint Task Force on Practice Parameters for Allergy & Immunology are available at http://www.JCAAI.org or http://www.allergyparameters.org.

Sun lotion chemicals as endocrine disruptors

Ultraviolet solar radiation is a well-known environmental health risk factor and the use of sun lotions is encouraged to achieve protection mainly from skin cancer. Sun lotions are cosmetic commercial products that combine active and inactive ingredients and many of these are associated with health problems, including allergic reactions and endocrine disorders. This review focuses on their ability to cause endocrine and reproductive impairments, with emphasis laid on the active ingredients (common and less common UV filters). In vitro and in vivo studies have demonstrated their ability to show oestrogenic/anti-oestrogenic and androgenic/anti-androgenic activity. Many ingredients affect the oestrous cycle, spermatogenesis, sexual behaviour, fertility and other reproductive parameters in experimental animals. Their presence in aquatic environments may reveal a new emerging environmental hazard.

Patch testing in suspected allergic contact dermatitis to cosmetics

Background. Increasing use of cosmetics has contributed to a rise in the incidence of allergic contact dermatitis (ACD) to cosmetics. It is estimated that 1–5.4% of the population is sensitized to a cosmetic ingredient. Patch testing helps to confirm the presence of an allergy and to identify the actual allergens which are chemical mixtures of various ingredients. Objectives. The aims of this study are to perform patch testing in suspected ACD to cosmetics and to identify the most common allergen and cosmetic product causing dermatitis. Methods. Fifty patients with suspected ACD to cosmetics were patch-tested with 38 antigens of the Indian Cosmetic Series and 12 antigens of the Indian Standard Series. Results. The majority (58%) of patients belonged to the 21–40 years age group. The presence of ACD to cosmetics was confirmed in 38 (76%) patients. Face creams (20%), hair dyes (14%), and soaps (12%) were the most commonly implicated. The most common allergens identified were gallate mix (40%), cetrimide (28%), and thiomersal (20%). Out of a total of 2531 patches applied, positive reactions were obtained in 3.75%. Conclusion. Incidence of ACD to cosmetics was greater in females. Face creams and hair dyes were the most common cosmetic products implicated. The principal allergens were gallate mix, cetrimide, and thiomersal.

The Challenge for Innovation in Direct Restorative Materials

During the past 50 years, a series of key UN conferences have established a framework to minimize human health risks from environmental exposures to key chemicals. In January 2013, more than 140 countries agreed to the text of new treaty to minimize Hg effects on the environment (the Minamata Convention). Dental caries is omnipresent around the globe, affecting 60% to 90% of school children and most adults, and producing discomfort that affects quality of life. Dental amalgam is frequently used to treat carious lesions and its use releases mercury into the environment. The best way to avoid the use of dental amalgam is to emphasize caries prevention. Alternatives to amalgam are suitable in some applications, but no replacement for amalgam has been found for large posterior restorations. For any restorative material, safety and environmental impacts are part of clinical risk assessment. Safety is freedom from unacceptable risks. Risk is a combination of probability of exposure and severity of harm. Best management practices are crucial to manage dental amalgam, but these impose additional that are disproportionately more for developing countries. The Minamata Convention seeks a phase-out of all mercury-based products except dental amalgam, where a phase-down is the present goal. For dentistry, the most important focus is the promotion of caries prevention and research on new materials.

Evaluation of cosmetic product exposures reported to the Milan Poison Control Centre, Italy from 2005 to 2010

INTRODUCTION

To the average consumer, "cosmetics" are not considered to cause damage to human health under normal conditions of use. Thus, cosmetic "safety" does not require any particular attention to the possibility that cosmetics may result in a toxic exposure, especially for children. Poison Control Centres (PCCs) provide specialized and rapid information for consumers and health professionals to ensure management of events related to the exposures to different agents, including Cosmetics. Poison Control Centres also represent a unique source of information to investigate the frequency and type of exposures to cosmetic and the related risks.

OBJECTIVE

An analysis of cases concerning human exposures to cosmetics collected from 2005 to 2010 by the PCC at the Ospedale Niguarda Ca' Granda (Milan, Italy) was performed.

RESULTS

During this period, 11 322 human exposure cases related to cosmetics were collected accounting for 4.5% of the total human clinical cases. Almost, all the requests for assistance came from consumers (53%) and hospitals (40%). The most frequently reported site of exposure was the consumer's own residence (94%). The exposures mainly involved children younger than 4 years (77%). No difference in gender distribution was observed (female 49%, male 51%). Almost, all of the exposures were unintentional (94%). Intentional exposures, mainly related to suicide attempts and accounted for 6% of cases involving persons aged more than 12 years. Personal hygiene products (30%), perfumes and hair care products (excluding hair dyes) (both 13%) were the most frequently involved categories. Symptoms were present only in 26% of the exposures and were mostly gastrointestinal (46%). Most of the cases were managed at home (43%) whereas hospital intervention was required in 38%.

CONCLUSION

Since the exposure frequency seems more likely to reflect product availability and accessibility to ingestors, our results call for closer attention to this type of hazard, especially for children younger than 4 years of age.

Comparison of Marketed Cosmetic Products Constituents with the Antigens Included in Cosmetic-related Patch Test

BACKGROUND

Currently, cosmetic series (Chemotechnique Diagnostics, Sweden) is the most widely used cosmetic-related patch test in Korea. However, no studies have been conducted on how accurately it reflects the constituents of the cosmetics in Korea.

OBJECTIVE

We surveyed the constituents of various cosmetics and compare with the cosmetic series, to investigate whether it is accurate in determining allergic contact dermatitis caused by cosmetics sold in Korea.

METHODS

Cosmetics were classified into 11 categories and the survey was conducted on the constituents of 55 cosmetics, with 5 cosmetics in each category. The surveyed constituents were classified by chemical function and compared with the antigens of cosmetic series.

RESULTS

155 constituents were found in 55 cosmetics, and 74 (47.7%) of constituents were included as antigen. Among them, only 20 constituents (27.0%) were included in cosmetic series. A significant number of constituents, such as fragrance, vehicle and surfactant were not included. Only 41.7% of antigens in cosmetic series were found to be in the cosmetics sampled.

CONCLUSION

The constituents not included in the patch test but possess antigenicity are widely used in cosmetics. Therefore, the patch test should be modified to reflect ingredients in the marketed products that may stimulate allergies.